Monthly Claim for Reimbursement

Forms and Documents

Document Name	Status
Form FNS 806-A Monthly Claim for Reimbursement FNS 806-A & B Form and Instruction	Modified
supporting statement 806A-806B 2-22-2010.doc Supporting Statement A	2010-02-23

IC Document Collections

IC ID	Document Title	Status
3005	Monthly Claim for Reimbursement FNS 806-A & B Form and Instruction	Modified

ICR Details

OMB Control No: 0584-0284	ICR Reference No: 200912-0584-003
Status: Historical Active	Previous ICR Reference No: 200609-0584-013
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: Monthly Claim for Reimbursement
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/26/2010
	Date Received in OIRA: 02/23/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2013	36 Months From Approved	03/31/2010
Responses	2,796	0	2,730
Time Burden (Hours)	1,398	0	1,896
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this collection is to collect data to determine the amount of reimbursement for meals and milk served.

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Authorizing Statute(s): PL: Pub.L. 109 - 85 4 Name of Law: Child Nutrition Act of 1966
   PL: Pub.L. 109 - 97 3 Name of Law: Richard B. Russell National School Lunch Act
   PL: Pub.L. 109 - 85 3(a)(10) Name of Law: Child Nutrition Act of 1966
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 48711	09/24/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 35	02/23/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Monthly Claim for Reimbursement FNS 806-A & B	FNS 806-B, FNS 806-A (Electronic), FNS 806-B, FNS 806-A	School Lunch/Breakfast/Snack Claim for Reimbursement ,   School Lunch/Breakfast/Snack Claim for Reimbursement ,   Milk Claim for Reimbursement ,   Milk Claim for Reimbursement

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,796	2,730	0	66	0	0
Annual Time Burden (Hours)	1,398	1,896	0	-498	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The state of Missouri no longer participates as a ROAP, therefore, the number of respondents has been reduced from 273 to 233 and the recordkeeping burden has been eliminated because SFAs are not required to maintain their records for more than three years which falls within their routine business practices. Therefore, the total burden has decreased from 1,896 burden hours to 1,398 burden hours.

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Annual Cost to Federal Government: $20,704

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/23/2010

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